# Surgery on the Road to the Land of Promise–Ιmpact of the Refugee Crisis on the Greek Healthcare System: Results from a Surgical Department of a Tertiary Hospital

## TL;DR

This study shows how the refugee crisis increased surgical workload in a Greek hospital, stressing the healthcare system and calling for better resource management.

## Contribution

The paper provides empirical evidence of the surgical strain on the Greek NHS due to the refugee crisis, focusing on specific conditions and operational impacts.

## Key findings

- 72.5% of patients required surgical procedures, with appendicitis and cholecystitis being the most common.
- Post-July 2015, there was a significant rise in perianal abscess, inguinal hernia, and cholelithiasis cases.
- Despite increased surgical demand, the average hospital stay remained unchanged at 3.9 days.

## Abstract

Background/Objectives: The surge in migration from the Middle East and North Africa due to conflicts has significantly impacted healthcare systems, particularly in Greece. This study investigates how the sharp increase in refugees and migrants after July 2015 has strained the surgical departments of the Greek National Health System (NHS). Methods: A retrospective analysis was conducted on 229 patients treated at the emergency department of a public hospital in Athens, Greece. Data were compared between two periods: January 2012–July 2015 (pre-July 2015) and July 2015–December 2018 (post-July 2015), with July 2015 chosen as the cutoff due to a significant influx of immigrants during that time. Results: Patients’ demographic details, diagnoses, and surgical interventions were analyzed. Results indicated a significant rise in surgical cases, with 72.5% of patients requiring procedures, notably for appendicitis (23.6%), cholecystitis (10.9%), lower extremity thrombophlebitis (9.6%), perianal abscess (8.3%), and inguinal hernia (5.7%). Post-July 2015, there was a notable increase in perianal abscess (12.2%), inguinal hernia (8.4%), and cholelithiasis (6.1%). However, the average hospital stay of 3.9 days remained unchanged. Conclusions: The findings reveal the profound economic and operational pressures on the NHS during the refugee crisis, highlighting the urgent need for resource optimization and policy reforms. Future studies should address long-term healthcare impacts to support more sustainable healthcare models amidst ongoing and future migration challenges.